The first question to ask about drugs for treating overactive bladder (OAB) is not which one is best; it’s whether you need one at all.

Most experts recommend trying non-drug treatments first. Bladder exercises, changing your drinking habits, and other lifestyle changes may do the trick, especially if your OAB symptoms are mild. And these measures avoid bothersome side effects that are common with overactive bladder drugs. But if your symptoms persist, adding a drug may help.

What’s the difference?

All overactive bladder drugs are about equally effective. But although their benefits are proven, they are also modest—don’t expect a dramatic improvement in your symptoms.

Different OAB medicines take different approaches to treating the condition:

Anticholinergics are the largest class of drugs for treating OAB. They work by blocking nerve signals that tell the bladder to contract. They may also increase the amount of urine your bladder can hold and reduce the urge to urinate.

Anticholinergics are sold under a variety of names, including darifenacin (Enablex), fesoterodine (Toviaz), oxybutynin (Ditropan, Ditropan XL, Oxytrol, Gelnique), solifenacin (Vesicare), tolterodine (Detrol, Detrol LA), and trospium (Sanctura, Sanctura XR).

Not all are available as generics. One medicine, Oxytrol for Women, is available without a prescription. You can learn more about it in this article.

Tricyclic antidepressants aren’t only for mental health—they can also treat overactive bladder. Drugs such as imipramine (Tofranil) relax the bladder, help reduce the urge to urinate, and help control leakage.

Beta-3 adrenergic agonists help the bladder muscles relax and enable the bladder to better fill and store urine. Mirabegron (Myrbetriq) is the first of this new class of drugs.

Hormones may also help women with OAB. Estrogen and desmopressin, a synthetic hormone, help fight incontinence, each in a different way.

Finding a drug you can live with

Many patients give up on OAB medicines because of side effects. Because the drugs typically provide limited relief, some people decide that the side effects aren’t worth it. However, side effects vary from person to person and from one drug to another. You may not experience side effects, and if you do, switching from one drug to another may be all it takes to find an effective treatment that doesn’t cause other problems.

Side effects may include:

  • Dry mouth
  • Constipation
  • Dizziness
  • Drowsiness
  • Blurred vision
  • Trouble remembering things

Making the choice

How do you and your doctor decide which OAB drug may be right for you? To begin with, some drugs may need to be ruled out because they may interfere with other medicines you take or make other health problems worse. Your doctor can watch for those conflicts. Make sure you tell her about every medicine and supplement you take.

Since all the drugs work roughly as well as each other, you may want to choose your drug based on price; some cost a lot more than others. Generic oxybutynin is inexpensive and may be worth considering if your doctor approves. It has a greater chance of side effects than some other OAB drugs, but you won’t know whether they affect you unless you try it.

To learn more about overactive bladder:
Botox for Overactive Bladder
Overactive Bladder? 8 Lifestyle Changes to Help Reduce Symptoms
Take Your Life Back! Staying Active with Overactive Bladder

Sources:
http://www.healthline.com/health-slideshow/overactive-bladder-medications
https://www.consumerreports.org/health/resources/pdf/best-buy-drugs/Overactive_Bladder-FINAL.pdf
http://www.healthline.com/health/overactive-bladder/anticholinergic-medications#Fesoterodine5
http://www.webmd.com/urinary-incontinence-oab/overactive-bladder-treatment-finding-best-options